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Study: MRI with Ultrasound Produces Better Biopsy Results for Prostate Cancer

MRI Seems to Help Diagnose Prostate Cancer, Preliminary Study Shows
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A study at the National Cancer Institute shows using both an MRI and ultrasound technology can help doctors pinpoint aggressive prostate tumors, an advantage over the normal biopsies for this type of cancer.

Ultrasound uses sound waves to give doctors a picture of the prostate. It's normally used to guide surgeons during biopsies of the prostate, but it often fails to give them images of aggressive tumors.

“Ultrasound ensures that the needles hit the prostate," Dr. Peter Pinto explained, "but we don’t use the ultrasound to direct the needles into where the tumor may be present.”

Pinto, head of the prostate cancer section at the National Institutes of Health, worked with Dr. Minhaj Siddiqui, lead author of the new study, which combined ultrasound with magnetic resonance imaging (MRI) to collect tissue samples to biopsy. An MRI uses radio waves to "map" the prostate. Siddiqui said in the study, the fusion of the two technologies improved the ability to get tissue samples from the tumors.

“MRI can tell us where tumors are hiding in the prostate that’s not normally sampled," he said, adding that 17 percent fewer low-risk cancers were diagnosed with this approach, compared to the usual procedure.
Pinto said this dual approach could save more lives. He explained that “the targeted MRI guided biopsy had a 30 percent increase in detection of high-risk prostate cancer as compared to the traditional biopsies performed today.”

This may be especially important for men at high risk of aggressive prostate cancer, like Ronald Briscoe. Prostate cancer runs in his family.

“My older brother, my father had it, and also my baby brother has it,” said Briscoe.

A recent study at the University of Utah showed that family history has a lot to do with a man's chances of getting prostate cancer. The data indicated that if a man's male relatives - uncles, grandfather, great-grandfather, as well as his father - had prostate cancer, his risk of getting it could be up to three times higher than normal.

Ronald Briscoe was one of 1,000 men at high risk for prostate cancer who participated in Siddiqui's study. One group had a biopsy using both ultrasound and MRI technology. The other group had standard ultrasound-guided biopsies. The men were followed for seven years.

Siddiqui plans more clinical trials, but said the results of this preliminary study are promising. “The benefit of [using MRI and ultrasound] is that we maximize our ability to detect the high risk cancers that matter and also potentially avoid the harm of detecting cancer which is clinically insignificant and unlikely to cause problems for the patient.”

Minhaj Siddiqui is currently an assistant professor of surgery at the University of Maryland School of Medicine and director of urologic robotic surgery at the University of Maryland Marlene and Stewart Greenebaum Cancer Center. He was a fellow at NIH when the study was conducted. Findings from the study were published in the Jan. 27 Journal of the American Medical Association.